If the dentist’s words “open wide” fill you with fear, help may be on the way.

A number of dentists, hoping to relieve anxiety, pamper their patients and bring them back for regular visits, are offering comforts typically reserved for a trip to the spa.

Heated chairs with massage pads, warm hand towels served on silver platters, televisions with DVD players and coffee and juice bars have lately been turning up at dental practices. A few dentists have even combined their offices with full-service day spas. So now your six-month checkup could be followed by a full-body massage.

A 2001 poll conducted by the American Dental Association showed that 23 percent of adults hadn’t gone to the dentist in the previous year because of fear of pain.

Perry Hall resident Linda Dulny was once a member of that fearful group, describing her early dental experiences as “horrendous.” But she no longer frets about going to the dentist and even looks forward to visits at the Towson practice of Albert Ousborne Jr., Patrick Ousborne and Thomas Keller.

“They are like family,” she says.

The Ousbornes, a father-and-son team, and Keller say they try to comfort their patients in every way possible.

“We want to strive for excellence in dentistry and in customer service,” says Patrick Ousborne, 38. “We try to make it a more positive experience rather than having people dread coming to the dentist.”

When patients enter the office, there is no counter with a sign-in clipboard. Instead, someone comes out to greet them.

In the waiting room, patients are offered fresh-baked cookies, cappuccino, hot tea, water or juice. During the appointment, patients can use headphones for music, watch television or have a warming massage pad placed on the back of their chair.

And after the visit, patients are given a warm, scented towel to wash their face and hands. Lip balm and even wine with the Ousborne and Keller label may be handed out.

“A lot of patients are older, and this is sometimes the highlight of their day,” says Albert Ousborne, who has been in practice 40 years. “It all comes down to making people feel that it’s going to be a positive experience. If we are running more than 10 minutes late, we give out gifts as a way of saying, ‘we respect your time.’”

Dulny, who says she enjoys the fresh-baked cookies, adds that all the amenities make a difference. “It shows me they are really trying to make me comfortable,” she says.

Dentist Kimberly Baer, owner of Bethesda Dental Spa, says she did a lot of research before opening a full-service spa as part of her dental practice last fall.

“We got into it from a relaxation standpoint,” Baer says. “We found that if we gave our patients a massage, the anesthetic worked better and lasted longer. We’ve had a really great response.”

Baer’s dental spa (her original practice in Bethesda, Baer and Associates, opened in 2002) offers a range of dental procedures as well as skin care services, laser hair removal and massage therapy. Most dental procedures come with a complimentary hand, neck or foot massage or mini-facial.

Prices for dental services are not above averages elsewhere, she says, even with the complimentary massages, and her practice takes most forms of insurance. Fees for full-service spa techniques are extra.

“We found it just makes it worthwhile to give our patients these free treatments,” she says, in part because of referrals. Baer says her practice is averaging about 36 new patients a month.

“It’s great. Especially for those people who just hate going to the dentist,” she explains. “People realize it’s just a regular dental office unless you want the extra services. Anyone who comes to my office or another office that is doing something like this is not going to go back to a regular dental office.”

Baltimore resident Kruti Mehta says she used to return to her hometown of Cleveland for dental check-ups because she didn’t feel comfortable with anyone but her family dentist. Then her dentist retired, and one of her fillings fell out. The self-described spa connoisseur heard about Bethesda Dental Spa and decided to give it a try.

“The minute you walk in, an aroma of vanilla and spices envelops you,” Mehta says. “There are big leather couches and little waterfalls with candles everywhere. You have no idea you are in a dental office.”

Mehta, a contractor, travels to the Washington area several times a week for work, but says the drive to the dental spa would be “well worth it” even if she wasn’t already in the area.

Baer’s operation is independent, but there is a chain of dental spas now in operation. Started in 2002 by California dentist Lynn Watanabe, the Dental Spa is now in five cities, including Pacific Palisades, Calif., the San Francisco Bay area, Ann Arbor, Mich., New York and Seoul, Korea.

“There is tremendous interest for what we are doing,” says John Chien, Dental Spa’s co-owner. “This is not for everyone. It’s not for all dentists and it’s not for all patients. But for those that do want this, the response has been extraordinary.”

Watanabe and Chien have formed the International Dental Spa Association and hope to promote the idea of combining the two services.

Watanabe defines dental spa, or spa dentistry, as “a facility whose dental program is run under the strict supervision of a licensed dentist. Services are provided that integrate both traditional and nontraditional dental and spa treatments,” such as massage therapy, skin care and body treatments.

The American Dental Association has not issued an official statement on the topic of dental spas, says Leslee Williams, manager of media services for the 147,000-member organization. The group does not keep statistics on how many boutique dental clinics are operating.

The association advises that ancillary services such as spa treatments should be performed by licensed individuals in accordance with local and state regulations.

Dentist Edward Grace, director of behavioral sciences for the University of Maryland Dental School, says there are many relaxation techniques taught to dentists but none involve those found at a spa.

“There is no data I know of that show dental spas have an influence on dental fear or pain,” Grace says. “I think most dentists will want to see studies first of why it works, why it is better and why they should do it.”

About half the population have some generalized anxiety about going to the dentist, Grace adds. But after patients have a good experience they usually get over their fear.

When it came time for Catonsville dentists Edward Leikin and Scott Baylin to design their new office last year, they considered many spa-like items. Now they feel they have a state-of-the-art facility that offers an open, inviting atmosphere where patient comfort is taken seriously.

Headphones, padded massage chairs, videos and DVDs are all standard. Hot towels delivered on silver platters are an elegant finishing touch. Brightly colored walls, hardwood floors and dental rooms without doors were all designed with patients in mind.

“I think patient comfort is the future,” says Baylin. “It’s a flexible situation. If there is something new that makes the patient more at ease then they are going to want it and seek out those that provide it.”

But even with the amenities they’ve included, Baylin adds, at the end of the day the level of dental service is what counts.

“You can do as much fluff as you want,” he says. “But if you don’t treat the patient as No. 1, your practice won’t be successful. Everything we do revolves around the patient and being in the patient’s best interest.”

Here are some tips to overcome dental anxiety, provided by the American Dental Association:

# Talk to your dentist. If you’re tense or anxious, tell your dentist and the dental staff. Getting your concerns out in the open will let your dentist adapt the treatment to your needs.

# Choose a time for your dental visit when you’re less likely to be rushed or under pressure. For some people, that means a Saturday or an early-morning appointment.

# If the sound of the drill bothers you, bring a portable audio player and headset so you can listen to your favorite music. During the visit, try visualization techniques - imagine yourself relaxing on a warm beach, for example.

The dental association offers these suggestions for finding a dentist:

# Ask family, friends, neighbors or co-workers for recommendations. Or ask your family physician.

# If you’re moving, your current dentist may be able to make a recommendation.

# Call or write your local or state dental society. Use American Dental Association’s online member directory at [url=http://www.ada.org]http://www.ada.org[/url] to search for dentists in your area.

# You may want to call or visit more than one dentist before making your decision.